Current Appraisal of Diagnosis and Treatment of Bronchogenic Carcinoma

¹ Assistant Clinical Professor of Medicine, University of Southern California School of Medicine, and Director, Department of Chest Diseases, City of Hope Medical Center

Truly adequate tools for early diagnosis of carcinoma of the lung are not available. Of most importance is the physician's acute sensitivity to the insidious nature of this disease and its great frequency in men past 40 with long smoking histories. In addition, routine x-ray films of the chest at frequent intervals, possibly on a communitywide basis, offer the greatest potential case finding means at the present time. Cytologic techniques are being explored and may have great utility in the future, but at present are too ponderous fo rroutine use. Pulmonary resection is the treatment of choice for bronchogenic carcinoma. It should be possible to carry out this procedure with an operative mortality in the neighborhood of 10 per cent, and a five-year survival of approximately 25 per cent of those patients in whom resection is possible. Management of the inoperable patient poses many difficulties. In the absence of metastases outside the chest, radiation therapy is often employed and offers a significant likelihood of potential benefits. Improvements in the techniques of radiation therapy, possibly in conjunction with appropriate chemotherapeutic agents, may extend the utility of this medium to a large number of patients who at the present time are beyond the scope of all available therapy.